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‘Gives Us What We’re Owed’: Why Healthcare Assistants Are on Strike

Healthcare assistants are the very backbone of the NHS. Forced to work above their pay grades for poverty wages, they're going on strike for the pay — and the recognition — they deserve.

(Credit: Unison East Midlands)

‘We feel taken advantage of,’ says Katarzyna Krzysztofik, a healthcare assistant (HCA) at the University of Leicester NHS Trust. ‘We feel like we’ve been used for a very long time, and now we are angry, disappointed, and sad.’ Krzysztofik has worked at the trust since 2018 and, for all six years, has been carrying out duties above her paygrade. She’s not alone. Across the country, HCAs, the majority of whom are women, are battling their employers for fair pay after spending years on the wrong pay band.

Healthcare assistants like Krzysztofik are paid appalingly low wages, with most earning just £22,383 a year. On the band two payscale, healthcare assistants should only be required to undertake personal care responsibilities such as feeding, bathing and toileting. But, for many years, says Krzysztofik, support staff in Leicester have been ‘doing clinical duties all the time, including electrocardiogram ECG tests, cannulation, looking after the patients with fractures, blood scans, sepsis screening, blood pressure [and] respiration.’ Not only are these jobs technically clinical duties, she says, they’re also ‘highly skilled’ and require adequate training. This is on top of sharing jobs with porters and housekeeping. These tasks fall under band 3 but HCAs are not being remunerated for it. For those with more than two years’ experience, they are missing out on around £2,000 a year.

HCAs at Leicester have never had an actual job description, unlike other members of staff. ‘Our job description was only saying that we would be allocated certain tasks, but the tasks were not named,’ says Krzysztofik. ‘We didn’t know what to do or what not to do, and that meant we could be asked to do anything so we were basically doing everything.’

But Krzysztofik also puts this down to the nursing staffing crisis currently plaguing the NHS. Last year, analysis by the Royal College for Nursing (RCN) found that there were 43,339 roles unfilled in England’s registered nurse workforce. Meanwhile, NHS waiting lists have grown by 70 percent. ‘We have a shortage of nurses,’ says Krzysztofik. ‘So, to help the nurses, we are given nurse’s tasks, but nurses are qualified to do this job, and we aren’t.’

Not only has this been this stressful for support staff, but it caused arguments between themselves and colleagues on the ward. ‘We used to argue about it a lot, because we felt that something wasn’t right,’ says Krzysztofik. ‘We knew we were being kept on a very low band almost minimum wage and that we were being asked to do things we weren’t qualified for, so we would complain. But then there would be arguments with management and nurses, and if we refused to do certain tasks, we’d get called lazy.’

Now, Krzysztofik and her colleagues are walking out to demand not just that they be paid according to their duties, but also that they receive back pay for the period to 2018, to compensate them for years of unpaid work.

Poverty Pay

Many HCAs are struggling to make ends meet on their current pay band. Sangeeta Doy Unison’s Lead Rep within the Leicester trust tells Tribune that one woman, a single mother, buys a jacket potato from the canteen in order to feed herself and her child. ‘She shares a bedroom with her 12-year-old son because that’s all she can afford,’ says Doy. ‘She only has £50 left at the end of the month, and her kitchen is so small that she has to keep her microwave in the lounge.’

This is the reality for many of the workers we all clapped for during the pandemic. And while HCAs are not in it for the money, says Krzysztofik, the cost-of-living crisis coupled with the low, and unfair, pay given to them means that some people are leaving to find better paid work elsewhere, further compounding the staffing crisis. ‘We have only been receiving a little bit more than the minimum wage,’ she says. ‘With the cost of living, bills and childcare expenses, many colleagues have been leaving the NHS to work in the private sector or for an agency.’

Another key point for the Leicester dispute is securing back pay for bank staff NHS agency workers who are not on full time contracts, who have so far been left out of previous pay offers. ‘Bank work is the backbone of the hospital if it wasn’t for bank work [the trust] wouldn’t be able to provide safe patient care,’ says Doy. ‘Bank workers have done exactly the same thing as the substantive workers so from a union point of view, it is about fairness and equity.’

‘These are people who were going in to work during COVID. They’re some of the lowest paid NHS staff. Some are literally earning a penny more than the national minimum wage,’ says Unison Northern Regional Secretary Clare Williams. She’s been supporting striking healthcare assistants in Teeside. ‘Teeside has some of the most deprived communities in the country. Sadly, the North East has the highest rate of children living in poverty. And we have the highest rate of people in work with in-work poverty. People’s wages are not keeping anywhere near the pace with the cost of living.’

Williams hears daily stories of hardship from healthcare assistants  ‘Our members are telling us they just cannot pay their bills. They’re struggling just to be able to pay the basics, the heating, the rent, the clothing. People do need to be able to earn a wage that means they can live. They feel really disrespected and unvalued.’

Fighting Back

Thankfully for the union, bringing people together to fight this dispute has been easy — because this is about getting people what they are owed. And Doy says workers have been empowered to get more involved. ‘We’ve got over 900 members now, and a lot of them out on strike have been in touch with us asking to become stewards and reps and be activists,’ says Doy. ‘And that’s what we need.’

When she spoke to Tribune, Doy had just finished all three picket lines in Leicester: at Glenfield Hospital, Leicester General and Leicester Royal. ‘It was very noisy lots of people, lots of public support, it was really amazing to see,’ she says. ‘We had police cars put their flashing lights on in support, and the ambulances, fire engines, and other people stopped by. It was nice’.

She adds: ‘We want this to carry on beyond this dispute, too we don’t want any employer to mess with anybody’s terms and conditions, and, if they do, we want to empower people to stand up and challenge them, because unions have worked, and we still do tirelessly, for these terms and conditions.’

HCAs across the country are determined to get the money they’re owed, not just for themselves but for their colleagues. When Doy bought her colleague, who shares a room with her son, a box of chocolates, she said this: ‘I don’t want your chocolates, I don’t want your charity I want you to work hard and get me the money I’m owed. I’ve worked hard for that money, and I want my back pay.’

‘There’s been hundreds of healthcare assistants on the picket lines,’ says Williams. ‘The solidarity is extremely strong. Support from members of the public, from other health workers has been tremendous. And of course, people get confidence from that. And it means a lot to people.’

Some healthcare assistants have already won, boosting the morale of those still taking to the picket line. HCAs in Luton and Bedfordshire recently won back pay for healthcare support staff, while colleagues in the Wirral, Sheffield and Manchester have secured pay rises as well as back pay. Late last year, HCAs in Mid Cheshire Hospitals NHS Foundation Trust (MCHFT) were able to secure a pay deal before heading out on strike. Sue, a HCA at the trust, says she was ‘overjoyed’ with the results, which included five years of backpay.

‘I can’t put words to how amazing it’s been to actually stand up to our trust who have walked all over us for years,’ she says. ‘We kept everyone informed and when people had the facts and were talking with each other they knew they had each other’s backs and felt confident. The trust sensed that confidence and I think that’s how we got the win.’ Vitally, Sue says, the extra money ‘literally… allow[ed] me to put food on the table.’

Following hard-fought campaigns, over 35,000 healthcare assistants have been moved onto a higher pay band. And, if the loud and lively picket lines are anything to go by, many more are set to join them.